Laura Rose Bolte, PH.D.

Individual provider Active NPI Psychologist · Fort Mitchell, KY

NPI 1366493298 · NPPES record last updated Apr 8, 2019

Key facts

NPI
1366493298
Entity type
Individual (NPI type 1)
Primary specialty
Psychologist 103T00000X
License
129227 (KY)
Practice address
305 Artillery Park Dr Unit 102
Fort Mitchell, KY 41017-2794
Phone
(859) 426-0200
Fax
(859) 426-0042
NPI assigned
May 15, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
129227KYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bolte Psychological Services, LLC Clinical Current Accepting new patients
Suzanne M. James, Psy.D., LLC Clinical Past
since Nov 6, 2008
Accepting new patients

Locations

305 Artillery Park Dr
Unit 102
Ft Mitchell, KY 41017
Phone (859) 426-0200

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 129227 KY
Psychologist 103T00000X 129227 KY Yes

Addresses

Primary practice location

305 Artillery Park Dr Unit 102
Fort Mitchell, KY 41017-2794

Mailing address

305 Artillery Park Dr Unit 102
Fort Mitchell, KY 41017-2794
Phone (859) 426-0200

Other identifiers

IdentifierTypeStateIssuer
0146114MedicaidOH
7100301780MedicaidKY

Other providers in Fort Mitchell, KY

All providers in Fort Mitchell, KY · Psychologist in Kentucky

Sources for this page

Verify at the official NPI Registry.